Research Article Details

Article ID: A15798
PMID: 28705172
Source: BMC Endocr Disord
Title: Endocannabinoid receptor blockade reduces alanine aminotransferase in polycystic ovary syndrome independent of weight loss.
Abstract: BACKGROUND: Evidence suggests that endocannabinoid system activation through the cannabinoid receptor 1 (CB1) is associated with enhanced liver injury, and CB1 antagonism may be beneficial. The aim of this study was to determine the impact of rimonabant (CB1 antagonist) on alanine aminotransferase (ALT), a hepatocellular injury marker, and a hepatic inflammatory cytokine profile. METHODS: Post hoc review of 2 studies involving 50 obese women with PCOS and well matched for weight, randomised to weight reducing therapy; rimonabant (20&#160;mg od) or orlistat (120&#160;mg tds), or to insulin sensitising therapy metformin, (500&#160;mg tds), or pioglitazone (45&#160;mg od). No subject had non-alcoholic fatty liver disease (NAFLD). RESULTS: Treatment with rimonabant for 12&#160;weeks reduced both ALT and weight (p&#8201;<&#8201;0.01), and there was a negative correlation between &#916; ALT and &#916; HOMA-IR (p&#8201;<&#8201;0.001), but not between &#916; ALT and &#916; weight. There was a significant reduction of weight with orlistat (p&#8201;<&#8201;0.01); however, orlistat, metformin and pioglitazone had no effect on ALT. The free androgen index fell in all groups (p&#8201;<&#8201;0.05). The inflammatory marker hs-CRP was reduced by pioglitazone (p&#8201;<&#8201;0.001) alone and did not correlate with changes in ALT. The inflammatory cytokine profile for IL-1&#946;, IL-6, IL-7, IL-10, IL12, TNF-&#945;, MCP-1 and INF-&#947; did not differ between groups. None of the interventions had an effect on biological variability of ALT. CONCLUSION: Rimonabant through CB1 receptor blockade decreased serum ALT that was independent of weight loss and hepatic inflammatory markers in obese women with PCOS without NAFLD. TRIAL REGISTRATION: ISRCTN58369615 (February 2007; retrospectively registered) ISRCTN75758249 (October 2007; retrospectively registered).
DOI: 10.1186/s12902-017-0194-2